Breast Cancer, Explained:What Oncologists Want You to Know

Cancer is a daunting word, and hearing it as a diagnosis can bring a wave of uncertainty that extends as an emotional weight, raising questions about one’s health, identity, family, and future. Even before answers arrive, the experience can be deeply personal. In the Philippines, where breast cancer remains the most commonly diagnosed cancer among women, as stated in a report from the International Agency for Research on Cancer’s Global Cancer Observatory, these questions carry particular urgency. 

Today, breast cancer care has improved tremendously, thanks to improvements in science that make early detection possible. Screening and early detection remain essential to identifying cancer sooner and guiding timely treatment.

To better understand the disease, Allure Philippines spoke with Filipino oncologists Aldine Astrid Basa, MD, FPCS, FPSGS, FPSBS, head of the Breast Center of Excellence of Healthway Cancer Care Hospital, and Julie Ann Tapispisan, MD, FPCP, FPSMO, associate professor at the University of Santo Tomas Faculty of Medicine and Surgery, about risk factors, screening recommendations, and why every man and woman should know the importance of early detection.

What is breast cancer?

“Breast cancer develops when changes in the DNA of breast cells allow them to multiply uncontrollably. Most breast cancers arise in the cells lining the milk ducts or the milk-producing lobule, says Dr. Basa. 

She explains that the abnormal cells can be confined in these ducts called in situ. “When cancer cells break through the boundary of the duct or lobule and enter surrounding breast tissue, the cancer is invasive,” Dr. Basa adds.  

Dr. Tapispisan further explains that the cancer really begins at the cellular level. “Often long before a lump becomes noticeable. So it doesn’t mean that if there is a lump, that’s where we will start. Sometimes without a lump, it is rapidly dividing.” That is why she notes that it is important to seek a doctor to assess whether a lump or mass is malignant or benign, because it will determine the treatment and management of the disease.

But Dr. Basa clarifies that once the cancer has spread to the blood, lymphatic vessels, or distant organs, it is now called metastatic breast cancer. 

Who is at risk of getting breast cancer?

“There is no single identifiable cause of breast cancer. It develops through the interaction of aging, genetic changes, hormonal exposure, environmental exposure, and lifestyle factors,” says Dr. Tapispisan. “Potentially modifiable risk factors include alcohol consumption, excess body weight, physical inactivity, and the use of menopausal hormone therapy.” 

While some risk factors are linked to lifestyle and environmental exposures, others are beyond one’s control. “Non-modifiable risk factors include increasing age, inherited gene mutations such as BRCA1 and BRCA2, and a family history of breast cancer. Remember Angelina Jolie? She tested positive for a BRCA1 mutation, which increases the risk of developing breast cancer. Early menstruation and late menopause are also considered non-modifiable risk factors,” Dr. Tapispisan says.

Can men get breast cancer?

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“Although breast cancer is more common among women, younger women and men can also develop the disease,” Dr. Basa explains. “Certain factors can increase the risk, including increasing age and female sex. Inherited risk can come from either side of the family. Having a risk factor does not mean someone will develop breast cancer, and having no family history does not mean someone is protected.”

Dr. Tapispisan emphasizes that yes, even men can get breast cancer. “If you look at the architecture of the male breast versus the female breast, there are fewer ducts in the male breast. But we still cannot pinpoint exactly how breast cancer develops in males. It can be genetic, but it can also happen in men without a family history,” she says. 

What are the symptoms of breast cancer?

“The most common sign of breast cancer is a palpable lump, but not all breast cancers present with one,” Dr. Tapispisan shares. “Other warning signs include skin changes, such as redness or peau d’orange, which gives the skin an orange-peel appearance, and nipple discharge, particularly if it is bloody. Some cancers may also appear as calcifications on a mammogram before they become large enough to feel, which is why screening is so important.”

Beyond changes in the breast’s appearance, other symptoms, such as persistent pain, may also warrant attention. “Breast pain can also occur, but it is important to consider its timing in relation to the menstrual cycle. If the pain persists even when hormonal influences are lower, such as around days five to 10 of the cycle, it is worth getting checked,” adds Dr. Tapispisan. 

When should you start screening for breast cancer?

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Dr. Tapispisan defines what screening means, because screening does not mean diagnostic. “When we do screening, it means the patient has no symptoms,” she says. 

Guidelines in screening for breast cancer are recommended to be scheduled depending on age. Dr. Basa shares that from 20 years old, women can do a monthly breast self-check, “to become familiar with how your breasts normally look and feel.” 

Then an annual clinical breast examination by a physician can be done from age 30. From age 40 and beyond, mammography, which is the main screening test, is an annual routine recommendation, and “earlier screening may be needed after assessing your risk with your  doctor,” Dr. Basa says.

However, Dr. Basa adds, “Screening should be individualized, as women with additional risk factors may need to begin earlier or undergo further assessment.” But she also cautions that while breast self-checks can help women become familiar with their breasts and notice changes, they cannot rule out cancer or replace recommended screening.

Why does early detection matter?

While cancer often sounds like an insurmountable obstacle, Dr. Tapispisan assures  that early detection creates a huge difference in the course of managing the disease.  “Once we get breast cancer early, the curative intent, the cure rate gets higher,” she says. “So the earlier the stage, the earlier you get the disease, the longer you’re going to live because you got it early.”

Not every breast cancer can be detected early, and screening is not foolproof. But knowing what is normal for your body, recognizing changes, and seeking advice from doctors when something feels different can be important steps toward getting answers.

For Dr. Basa, seeking medical advice is also the beginning of understanding the treatment options available. “Doctors consider the cancer’s stage, type, grade, ER/PR and HER2 results, and sometimes additional molecular tests. They also consider overall health, menopausal status, fertility concerns, and the patient’s preferences. Treatment planning should involve a multidisciplinary team,” she explains.

Breast health is not about living in fear of the Big C. It is about giving yourself the knowledge to ask questions, the confidence to seek care, and the chance to act when it matters.